ACUTE HAEMATOGENOUS OSTEOMYELITIS OF THE LONG BONES

Abstract

Acute haematogenous osteomyelitis in children occurs in metaphysis of a long bone, and the diagnosis is usually made within 48 hours of the onset of symptoms. From 1985 to 2001 we identified 682 cases with admission diagnosis of acute haematogenous osteomyelitis, which were treated in our hospital. Early diagnosis is essential to successful treatment. We excluded all patients without either radiological or bacteriological confirmation of the diagnosis those with a history of penetrating wound. Of 682 cases included in the full series, 320 or 47% fulfilled the diagnostic criteria. Of 320 cases, 173 (54%) the infection were on the right and 147 (46%) on the left. Five cases were multifocal, 47 cases were aged one year or less, in percent 14.6%. The principle of treatment were: identification of the organism, selection of the correct antibiotic, delivery of the antibiotic in sufficient concentration and for sufficient duration and arrest of destruction. In about 80% of cases Staphylococcus aureus was isolated. The reason for a fall in the incidence of Staphyloccocus aureus are not clear. Improvements in living standards, personal hygiene, and in the general health of population may well be responsible for decreased prevalence of Staphylococcus aureus. Oral administration of antibiotics is instituted after an initial good clinical response is seen during intravenous administration, and generally we use parenteral antibiotics for the first 21 days. Long-term follow-up of all patients is necessary, including the patient with an apparantly good early result.